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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Greg on November 4, 2003, at 21:56:25
I've been taking Adderall XR, 10mg, 2x daily for about a year and a half now. It's been primarily for fatigue as I work extremely long hours, but I do have a mild case of ADD. Over the last five months or so the Adderall hasn't been doing anything for me. I'll take a week or two break from it and then start up again, but after a couple of days, it stops working again.
I met with my Psych today and talked him into switching me to the Dex Spansules, 15mg, 2x daily. I'd heard from a few people that the Dex was a better med.
I'd be very interested in hearing from anyone who has experience with both and can give me your opinion on which you think is the most effective. I'm open to all suggestions and ideas.
I thank you for your input and appeciate your time.
I hope you all are doing well.
TIA,
Greg
Posted by Ame Sans Vie on November 5, 2003, at 11:02:48
In reply to Adderall XR vs Dexedrine Spansules, posted by Greg on November 4, 2003, at 21:56:25
Hi Greg,
I have a few opinions and a few suggestions -- I take Adderall XR 30mg once daily for mild ADD, CFS (chronic fatigue syndrome), and as an adjunct for cyclothymia (90% of the time dysthymic/depressive; 10% of the time agitated/hypomanic). I also take Klonopin (6mg), Xanax (6mg), Prozac (20mg), and am supposed to take a little Ativan (2-4mg) or meprobamate (800mg) if I deem it necessary. In addition to the depression, CFS, and ADD, I have social phobia, panic disorder, agoraphobia, mild OCD, and fibromyalgia. All symptoms of my disorders have been relieved completely by my current med cocktail. Just wanted to give you a little background so you can better understand my situation and take my many prior symptoms into account when considering the experiences and advice I give you.
A quick note in case you aren't aware of the exact composition of these drugs:
~~Dexedrine Spansules 15mg = 15mg dextroamphetamine sulfate
~~Adderall XR 10mg = 2.5mg dextroamphetamine sulfate, 2.5mg dextroamphetamine saccharate, 2.5mg amphetamine sulfate, 2.5mg amphetamine aspartateUntil very recently, I thought dextroamphetamine was superior to Adderall. I'd taken Adderall XR in the past and didn't notice much benefit -- but when I tried it before, I wasn't taking any other medications. For a while there my mother was convinced that all my problems stemmed from my horrible childhood ADHD (and probable oppositional defiant disorder) which regressed to mild ADD around the time I turned 16. This was why I stopped all other meds (including benzodiazepines -- big mistake) for a couple months to try stimulants alone. So obviously my hiatus from other meds influenced my initial response to amphetamines. This doctor was convinced that the Adderall would "cure" me if the dose were raised high enough, and so he raised it up to four 30mg capsules each morning -- a pretty huge dose. Didn't do a thing for me either way though.
That was about a year and a half ago, and perhaps five months ago I began taking Dexedrine Spansules along with my other meds which were at the time, I believe, Klonopin 12mg and Ultram 400mg. I found the Spansules had an effect which, considering my past experience with the d-amphetamine in Adderall, surprised me. Unfortunately they only lasted five hours tops, and seemed to take forever to take effect. I asked my pdoc at our next appointment to switch me to an immediate release formulation, so we tried DextroStat 15mg three times daily. Each tablet lasted just as long as the "Spansules" but kicked in much more quickly. I noticed great decreases in my depression and ADD symptoms, but my CFS wasn't noticeably improved. I continued to take it up until one week ago, regardless -- I asked my pdoc to give Adderall XR another shot at my appointment last Wednesday. I suspected the racemic amphetamine would be more stimulating than just the d-amp that's present in Dexedrine/DextroStat. Luckily, I suspected right. I've been full of energy and sleeping very regularly during the past week; before the Adderall, I was getting ten hours of sleep every three or four days, if I were lucky. Now I fall asleep right away upon getting into bed and sleep straight through from 11:00-6:00 without even needing an alarm clock to wake me up, lol.
Obviously now I'm more of an Adderall advocate, but that by no means is to say that you should be discouraged from giving d-amphetamine a shot. My course of action if I were you, however, would be to talk with your doctor about using an NMDA-antagonist along with the amphetamines to prevent development of tolerance. I take the over-the-counter NMDA-antagonist dextromethorphan at 60mg daily (dextromethorphan is the cough suppressant found in cough formulations made by Robitussin, Vicks 44, et al.). I also take DLPA (dl-phenylalanine), an over-the-counter amino acid which aids in the production of dopamine, noradrenaline, adrenaline, thyroid hormone, and alpha-phenethylamine (the "chocolate amphetamine") amongst other things. It also inhibits an enzyme that destroys naturally-occurring morphine-like substances in the brain (endorphins/enkephalins), thus increasing their availability and activity thereby causing a decrease in perception of discomfort (be it physical or psychological).
Hope this helps some!
Michael
Posted by Kacy on November 5, 2003, at 12:58:16
In reply to Re: Adderall XR vs Dexedrine Spansules » Greg, posted by Ame Sans Vie on November 5, 2003, at 11:02:48
Ame Sans Vie, how do you balance taking your vitamin C and phenylalanine when you take the Adderall? I mean, when do you take them so the C doesn't interfere with the stimulant but you get the C support for the phenylalanine? Do you take all your C at night? If you took a time-released multi-vitamin with C in it, when would you take that? Is C stored or is it used up immediately? Thanks for any help.
Posted by wondering on November 8, 2003, at 10:18:23
In reply to Re: Adderall XR vs Dexedrine Spansules » Greg, posted by Ame Sans Vie on November 5, 2003, at 11:02:48
I too am very interested in hearing about experiences with Adderall vs. Dexedrine.
I was diagnosed with depression and ADHD (inattentive) a couple months ago (mid-40s). Started on Wellbutrin for a month or so, then my doc added Adderall XR. Started with 5 MG for a week, then have upped by 5 MG each week. Am now at 20 MG.
My reaction to the Adderall seems quite mixed. At this dose, about 30 to 45 minutes after taking in the AM, I do feel more focused. I do yoga in the morning and find that my practice is much improved (able to breath more deeply and regularly; more focused). When I get to work, although I’m definitely more focused, I've been noticing a lot more neck and shoulder tension (I tend to carry lots of tension in neck "normally"), and find myself sort of holding my breath. This seems paradoxical to the ability to relax and focus in Yoga. When I do notice the tension, I do seem to be able to "let it go," but as I get back into a task, the tension is back.
Whatever positive effect I seem to get in focusing (along with the muscle tension) wears off quickly, and about 3 or 3.5 hours after taking the dose, I feel very tired. After an hour or so of fighting the fatigue, I feel sort of ok (when the second half kicks in), but don’t feel much, if any, benefit over baseline. Later in the afternoon, I feel sort of ill, like I’m coming down with the flu or something, complete with slight swelling to in neck glands.
This pattern has been very consistent for the past couple days. I’m wondering if perhaps some of the longer acting amphetamine salts in Adderall "don’t agree with me" or something. If that is possible, I thought that perhaps Dexedrine alone might work better for me. I also think that whatever I take, I'd prefer immediate release, so I have more control over timing.
Any input from folks who have experience with Adderall and/or Dexedrine would be much appreciated.
Also, any thoughts on alleviating the muscle tension would be appreciated. Might you expect more or less muscle tension from Dexedrine?
My neck has actually gotten a bit sore from the tension. I’m also grinding my teeth at night. I read that Neurontin can help with the teeth grinding, but have read mixed things about it, and have no idea if it would help with the neck tension during the day (or would it just cancel out the stimulant effect?).
This is the end of the thread.
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